Pitney Bowes      Description

Introduction

Pitney Bowes, Inc. (Pitney Bowes) has a well-established reputation for valuing and investing in the well being of its employees.  Pitney Bowes' Power of 2 initiative is a multi-dimensional, highly integrated health care and welfare benefit strategy that uses data to drive program evolution and improvement.  The central theme of Power of 2 is the shared responsibility and commitment from the employee and Pitney Bowes to work together for improved health and well-being.  In 1993, Pitney Bowes piloted the first phase of the Power of 2 (Health Care University) in response to rapidly rising health care costs.  Rather than cut back on benefits or shifting cost to employees, Pitney Bowes remained firm in its commitment to employees, and continues to "raise the bar" for their health care strategy though fact-based decision making an dongoing analyses of program effectiveness.

Through Health Care University and Power of 2 programs, Pitney Bowes integrates all areas of health care including demand, disease, and disability management.  The initiative is designed to address health care needs for participants, regardless of current health status.  It also focuses on ensuring participant health care access to efficient providers, and maximization of participant interaction with the health care system.

Program Mission

To optimize organizational and employee health and productivity.

Program Objectives

• Enhance health and productivity outcomes
• Manage health care cost to 0%
• Avoid cost shifting/reward health behaviors
• Enhance benefits
• Measure results to quantify impact and to direct/improve program

Pitney Bowes supports good health and productivity through an integrated program of screening and early detection, support of appropriate access to health care, management of health care for individuals at all levels of health, and timely, safe and appropriate return to work.  Data regarding participation, outcomes (self-reported and clinical), health and disability claims, and clinic records are captured and utilized in integrated analysis to assess the impact of various initiatives, and to provide direction for program focus and improvement.

A significant portion of services are delivered on-site.  The four components of the strategy are:

• Health Care University (HCU)
• On-site medical service access/integration
• Disease management
• Disability management

Health Care University

HCU is an initiative that supports all of the other components of the Power of Two program. Convenient access is a central tenet of the HCU. This access is provided via a wide variety of health initiatives provided at the worksite. 

HCU also supports the Power of 2 initiative by providing credits and incentives for participation in activities that can help employees to enhance or maintain their health and well-being. Activities that are offered through HCU include: health screening/appraisal, health education, disease management, on-site fitness centers, self-care/consumerism, or other programs designed to assist Pitney Bowes employees to maintain or enhance their health. 

If an individual earns 6 “credits” within a term (September–June), they receive a financial award which could be applied toward future benefit purchase. Many activities are provided on-site for convenient access, and are fully covered under the medical plan if a physician’s office visit is required. 

On-Site Medical Services

In-house medical services include primary care, health screening and diagnostics, disability management, health counseling, patient advocacy, and, where appropriate, referral to community resources for care. Primary care physicians, nurse practitioners, physician assistants, certified occupational health nurses, and health educators/counselors staff the on-site centers.

After review of the cost-effectiveness and treatment efficiency of the on-site services, Pitney Bowes made the on-site clinics a participating provider of Pitney Bowes’ health care network in 1998. This analysis also provided Pitney Bowes with direction regarding the types of high-volume services or specialties that would prove to be well-utilized and cost efficient. 
Based on this review, Pitney determined that dermatology was a needed specialty due to the demand for services and the cost of coverage in this area. They also decided that disease management should be offered through the clinics because the analysis showed that the clinics were offering more counseling and treatment guidance for patients than community providers, resulting in lower overall treatment cost and need for additional diagnostic services.

Disease Management Program

Pitney Bowes offered a Diabetes Management Program that began in 1997, and ran over a ten-month period. The program included a series of educational presentations about controlling diabetes, access to a diabetes nurse educator for individual assistance, and Hemoglobin A1c (HbA1c) monitoring at six-month intervals. HbA1c levels were measured as a marker of blood sugar control over a several month period for participants, while blood glucose testing was used by participants to measure shorter-term control and to provide immediate feedback. Finally, self-reported measures of program satisfaction, quality, and value were used to provide qualitative feedback for program improvement.

Participants included Pitney Bowes employees, dependents, and retirees. Education and HbA1c screenings were done at the worksite and in the on-site clinics for participant convenience and to increase compliance.

Disability Management

Pitney Bowes Disability Assistance Department administers the Short and Long-Term Disability plans, as well as a supplemental benefit for the Worker’s Compensation Program. The Disability management approach focuses on early intervention by requiring employees to report claims by their fourth day of absence. To accomplish this, Pitney Bowes employees and their treating Physicians can use an telephonic Interactive Voice Response (IVR) system that is available 24 hours per day, 7 days per week. Using diagnostic criteria, Service Representatives triage these claims and make referrals to nurse case managers where appropriate. This nurse and a claim examiner partner to manage a case to resolution. 

An important aspect of case management is the integration of medical and disability case management. Nurse managers break down barriers employees may encounter and focus on the “whole person.” Pitney Bowes is committed to safe return to work, and uses transitional employment where appropriate. Available resources in the area include the Corporate Medical Director, consulting physicians, safety engineers, and ergonomists, as well as on-site medical clinicians. Analysis of data from the disability management program indicated that physical therapy and cardiac rehabilitation services could have significant impact in employee return-to-work results. Based on this analysis, physical therapy and Phase 3 cardiac rehabilitation services are now both offered on-site to employees.